What does employee health insurance cover?

What's covered by employee health insurance depends on the business health insurance package you opt for and how much you’re willing to pay for premiums. Here's what you need to know.

Benefits 101

⋅ min read

Employee health insurance is no longer just a nice to have for many businesses. It’s a great way to show your commitment to the mental and physical well being of your hardworking staff, and it’s a benefit that many jobseekers now see as essential. In fact, 87% of employees consider health and wellness offerings when choosing an employer. Find out what’s covered by this type of insurance, how it works and the different types of policy on offer.

What is employee health insurance?

Employee health insurance is another term for private medical insurance. Businesses can offer this benefit to their employees to make paying for private healthcare one less thing to worry about. The rising cost of healthcare – coupled with growing NHS wait times – can be very stressful, particularly if you’re concerned about an issue with your health. As an employer, your people will thank you for taking this financial burden off their shoulders.

Why offer employee health insurance?

Aside from the obvious – keeping your employees healthy and happy – there are plenty of reasons to offer private health insurance.

There’s a direct correlation between employee health and productivity, so it bodes well for you that your staff are feeling their best. Health is inextricably connected to happiness, which is in turn linked to productivity. This is proven by the University of Oxford, who found that happy workers are 13% more productive

Plus, good employee health not only reduces sick leave and absenteeism, it reduces hiring costs and cuts staff turnover rates. One study found that 80% of people continue to work when they’re ill, which costs the UK economy £15.1 billion every year. So encouraging your team to look after themselves just makes sense – and prevention is always better than cure. 

Ultimately, you’ll have a hard time finding a reason not to offer employee health insurance. Ready to explore your options for private health insurance? Book a demo with Ben and we’ll show you how easy it is to get set up, from working with a dedicated benefits consultant to getting your team up and running with help from our onboarding team.

Who is it for? 

Everyone! No matter the size of your business, there’s a health insurance offering for you. You usually need at least two employees to take out a private health insurance package, and you’ll probably qualify for small business health insurance if you have fewer than 250 employees. Aetna, one of the providers we work with, lets you browse by company size, industry and product, for example. Each provider offers different plans so you can pick the one that best suits your organisation and people.

In general, it’s best to cover all of your employees if you’re going to be offering a corporate healthcare policy. This will help to prevent any accusations of unfair discrimination or special treatment if some employees allege that they’re not covered.

How does employee health insurance work? 

As a business, you’ll typically pay a monthly or annual fee for your employees’ healthcare plan (paying monthly usually works out as cheaper overall). Your employees can then make claims for any private healthcare they receive, for instance, if they see a private orthopaedic doctor for a problem with their back. If an employee makes a claim, they’ll typically pay a small excess, and the insurance provider will cover the rest (as long as the condition is covered by the plan).

How much does it cost?

When you choose an employee health insurance plan, the provider will usually take a few factors into consideration:

  • Age - They might take the average age of your workforce to give a fair quote.
  • Work environment - If your work is based on a construction site, this is likely to carry more risks than a corporate office block.
  • Location - The price you pay for insurance will vary depending on where you’re based in the UK.
  • Excess - The cost of your employees’ excess will impact the premium you pay. The higher the excess, the lower the premium.

What does it cover? 

That depends on the business health insurance package you opt for and how much you’re willing to pay for premiums. More basic policies usually cover the costs of in-patient treatments (like tests, surgery and day-care surgery). Whereas some policies extend to out-patient treatments (like specialists and consultants) and might pay you a small fixed amount if you have to spend any nights in an NHS hospital. Other policies will include more specific offerings like physiotherapy or mental health solutions. 

Small businesses might prefer to opt for a basic plan as it will be cheaper, but you’re free to offer more coverage with a comprehensive plan. Take a look at the providers we work with at Ben to get a feel for what’s included.

Bear in mind that health insurance is designed to cover new conditions which occur after your policy start date, so employees may not be able to claim for conditions that began before they took out the policy.

Is emergency care covered?

Not usually, but employees can use private medical insurance to make any overnight stays in hospital after receiving care more comfortable. If patients have any new symptoms which require emergency care, they should visit A&E or a private urgent care centre as normal and get the help they need that way.

If you’re thinking of offering employee health insurance at your company, great! Ben works with a range of providers to help your employees access top notch services, skip wait times and enjoy peace of mind that their health is taken care of. With health insurance ranking in the top three most sought after employee benefits, there’s never been a better time to give your workforce the best benefit of all. Book a demo now to get started.

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